Format

Send to

Choose Destination
BMC Med. 2013 Aug 29;11:191. doi: 10.1186/1741-7015-11-191.

Systematic review of clinical practice guidelines in the diagnosis and management of thyroid nodules and cancer.

Author information

1
Center for Evidence-based Health Care, Taipei Medical University - Shuang Ho Hospital, Taipei, Taiwan. kelvintam@h.tmu.edu.tw.

Abstract

BACKGROUND:

Given the uncertainties regarding thyroid nodule assessment and management, physicians require systematically and transparently developed recommendations. This systematic review assesses the quality and consistency of the recommendations of international clinical practice guidelines (CPGs) for the diagnosis and management of thyroid nodules and cancer to assist physicians in making appropriate recommendations.

METHODS:

The CPGs on the management of thyroid nodules and cancer published before June 2013 were retrieved. All the reviewed guidelines were in English. Four reviewers independently assessed the rigor of guideline development by using the Appraisal of Guidelines Research and Evaluation II (AGREE-II) instrument, and their reported evidence was evaluated.

RESULTS:

Ten eligible guidelines were included: nine had been developed by professional organizations, and the remaining guideline was endorsed by an independent regional body. Three guidelines achieved a score of greater than 50% in all six AGREE-II domains. Guidelines scored highest on the measurement of 'scope and purpose' (≥61.1% for eight CPGs) and lowest on the measurement of 'applicability' (≤38.5% for five CPGs). The overall quality ranged from 3.0 to 6.25 on a seven-point scale on the AGREE-II tool. Most CPG recommendations on the management of thyroid cancer were relatively consistent. Guidelines varied regarding the indication of fine-needle aspiration for thyroid nodules, as well as in their suggestions for postoperative radioiodine ablation.

CONCLUSIONS:

Our analysis showed that the current CPGs varied in methodological quality. More effort is needed to improve the quality of recommendations on the diagnosis and management of thyroid nodules and cancer.

PMID:
23987922
PMCID:
PMC3765955
DOI:
10.1186/1741-7015-11-191
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center